In the modern world, the problem of stress is relevant and is actively expressed among the professions of the humans’ interaction system, including in medicine. The daily work of a medical worker is associated with constant difficult professional situations, often requiring quick adoption of vital decisions, and, as a result, adversely affecting both mental and physical health of employees, their performance, interpersonal communication, which can lead to the development of professional stress burnout syndrome. South Carolina House Calls faces the above-mentioned problem which led to increases in patient complaints, deterioration of organizational communications and culture, and some other negative implications affecting the level of the facility’s competitiveness.
In turn, the goal of preventing burnout among medical staff is to maximize professional and personal readiness to restore physical and mental health and to preserve it in the process of providing specialized care. When an employee exhibits and develops signs of job stress and burnout, it is necessary to pay attention to the improvement of his/her working conditions (organizational level), the nature of the existing relationships in the team (interpersonal level), personal reactions and incidence (individual level) (Wolf & Gillis, 2017). A significant role in the fight against CMEA is assigned, first of all, to the health worker himself/herself. After observing certain recommendations offered in the process of specialized training, the employee will be able to not only to prevent the occurrence of job stress and burnout, but also achieve a reduction in their severity.
Assessment for Clarifying the Issue
The diagnostic phase will begin after a face-to-face discussion of the proposal and details of the training with South Carolina House Calls Primary Physician Columbia SC. Five key groups of symptoms characteristic of job stress and burnout can be distinguished (Kurapati, 2019):
- Physical symptoms (fatigue, physical fatigue, exhaustion, sleep disorders, and specific somatic problems).
- Emotional symptoms (irritability, anxiety, depression, guilt, hopelessness).
- Behavioral symptoms (aggressiveness, callousness, pessimism, cynicism, dependence on psychoactive substances).
- Symptoms associated with work (absenteeism, poor quality of work, lateness, abuse of work breaks).
- Symptoms in interpersonal relationships (formality of relationships, detachment from clients, colleagues, dehumanization). The presence of these symptoms in workers determines the need for this training.
Diagnosis of the presence of symptoms of burnout in South Carolina House Calls employees will be carried out according to the Boyko method. The methodology is a questionnaire containing 84 questions; estimated answer options are “yes” or “no.” The time allotted by the subjects to fill out the form is not strictly limited, but a recommendation is made that a participant should not think about the text of the question for a long time. Surveys can be conducted both collectively and individually (Kurapati, 2019). The technique allows diagnosing three phases of the process: stress, resistance, and exhaustion. This division is due to the dynamic nature of burnout, with each of the three phases corresponding to four symptoms that make up its symptomatic picture in the diagnosis.
Intervention Strategies
As a methodology for the training, cognitive-behavioral therapy will be used. It helps to reconsider outdated beliefs and attitudes, improve self-esteem and relationships with other people, and gain new habits. Surveys that evaluated stress management strategies among general practitioners have shown that cognitive-behavioral psychotherapy skills are helpful in combating job stress and burnout (Shariatkhah et al., 2017). In addition, group methods are more effective from an economic point of view than individual counseling. Also, according to the results of published studies, an important point in solving the burnout problem is restoring the balance between work and personal life (Jaworska-Burzyńska et al., 2016; Ruotsalainen et al., 2015). During therapy, the consultant helps the client to independently determine the wrong patterns of thinking and find effective solutions to problems. The practice of mindfulness enhances stress tolerance and internal emotional balance. The full course of therapy consists of group sessions with a psychologist three times a week for four weeks.
The objectives of the optimal training model for burnout therapy, with evaluation according to KPI principle, are as follows:
- Training in self-regulation and constructive behavior in difficult situations;
- The formation of a positive attitude towards reality through reflection and cognitive reappraisal of basic life values;
- Rational choice of specialty and place of work;
- Development of professionally important qualities in various situations of interaction;
- The formation of an individual style of activity and professional competence, creativity, etc.
Expected Results and Overall Evaluation
The main goal of the program’s correctional model – prevention and correction of job stress and burnout – and the core tasks: improving the adaptive capabilities of the individual, regulating one’s functional state, creating a positive attitude towards others and one’s profession, developing personal reflection, teaching interaction skills in difficult conflict situations can be identified. The overall concept of training is built on the Kolb model, with its four stages given below (Kolb & Kolb, 2017). Each of four weeks of training corresponds to one stage, according to their sequence:
- Concrete experience – any person should already have some experience in the field or field that he/she wants to learn.
- Observation and reflection – this stage involves thinking and analyzing a person’s experience and knowledge.
- Formation of abstract concepts and models or abstract conceptualization – at this stage, a certain model is being built that describes the information received, experience. Ideas are generated, relationships are built, new information is added regarding how everything works and how all is arranged.
- Active experimentation (testing in new situations) – the last stage involves experimentation and testing the applicability of the created model, concept. The result of this step is an immediate new experience, and, next, the circle closes.
Feedback and Ethical Issues
The final stage of the correction program involves a joint analysis and discussion both at the group level (classes, seminars) and in the framework of individual consultations with participants about the results of the training work. Timely repeated diagnosis of job stress and burnout is carried out. The skills of self-assessment of own condition and recognition of burnout symptoms (self-diagnosis) are being taught; the subjects are familiarized with the test results. Based on a set of measures, the main directions and recommendations are formulated aimed at preventing the syndrome of emotional burnout and maintaining mental health. Further work can be carried out both in the form of consultation conversations, and in conducting additional trainings with the choice of the most effective tasks. In order to ensure ethical compliance, confidentiality of the test results of the training participants should be ensured. Thus, in general, the project of diagnosis, training, and evaluation of results will include five stages:
- The diagnostic stage – conducting clinical and psychological diagnostics.
- Information-motivational stage – forms the client’s motivation to communicate with a consultant and to participate in a psychotherapeutic group.
- Stage of organization of a psychotherapeutic group – it forms an empathic psychotherapeutic environment and expands the positive motivation for psychotherapy.
- The stage of the psychotherapeutic process is the consistent harmonization of the personality through the client’s awareness of himself/herself and other people, the integration of the mental and physical spheres, the release of authentic desires and goal setting.
- The integrative stage is the generalization and assimilation of the received psychotherapeutic experience with the projection into the future.
References
Jaworska-Burzyńska, L., Kanaffa-Kilijańska, U., Przysiężna, E., Szczepańska-Gieracha, J. (2016). The role of therapy in reducing the risk of job burnout – A systematic review of literature. Archives of Psychiatry and Psychotherapy, 4, 43-52.
Kolb, A., & Kolb, D. (2017). The experiential educator: Principles and practices of experiential learning. Experience Based Learning Systems.
Kurapati, R. (2019). Burnout in healthcare: A guide to addressing the epidemic. Sajjana Publishing.
Ruotsalainen, J., Verbeek, J., Mariné, A., Serra, C. (2015). Preventing occupational stress in healthcare workers. Cochrane Database Systematic Review, 4, 1-155.
Shariatkhah, J., Farajzadeh, Z., & Khazaee, K. (2017). The effects of cognitive-behavioral stress management on nurses’ job stress. Iranian Journal of Nursing and Midwifery Research, 22(5), 398-402.
Wolf, M., & Gillis, S. (2017). The other side of burnout: Solutions for healthcare professionals. Dog Ear Publishing.
Appendix A
TRAINING/CONSULTANT AGREEMENT _________________________________,
Therapist/Consultant
Philosophy
Burnout syndrome is a destructive process for the human personality, which most often occurs due to a high concentration of professional stress in human activities. In this regard, the specialists who are most susceptible to burnout are traditionally medical workers. The stress of medical workers is caused by a number of specific features of the profession: it is a huge responsibility for the life and health of patients, an uneven mode of work with night and day shifts, and being in situations of caring for dying patients, which negatively affects the adaptive abilities of the body and mental health in general.
Our primary role is to decrease the occurrence of job stress and burnout through training built on the Kolb model for better consolidation of knowledge in the field of counteracting job-related stress.
Confidentiality
Outside the training, as well as during coffee breaks, participants are not allowed to discuss other participants. The collection of personal data of the training participants occurs only to the extent necessary for their technical processing. The sale of the collected data or its transfer to third parties is absolutely excluded.
Consultation
The Training Company staff provides group and individual consulting in order to enable the highest and most effective level of the Client (South Carolina House Calls) performance and job satisfaction. I give the Training Company professional staff permission to consult about our employees needs, skills, and prospects.
Agreement for Training/Consulting
The services to be provided by a coach and consultants are designed collaboratively with our client/s. Our services on training and consultanting are usually provided at our facilities, but their provision can be organized in the Client’s organization premises. Fees are agreed per one participant, according to the number of training hours, as well as the necessity and scope of individual consultations.
Signatures of the Parties:
Client Signature _____________________________________________ Date
Client Name:
Training Service Provider Signature________________________________________Date_________________